Kornimate/medical-research-clean huggingface dataset:
psychosis: early detection, intervention and prevention

Conditions: Prodromal Schizophrenia; Psychotic Disorders; Severe Bipolar Disorder With Psychotic Features; Severe Major Depression With Psychotic Features

Summary: the primary aim of this application is to conduct a randomized, controlled clinical trial of a specialized mental health service delivery system specifically developed for prodromal psychotic disorders. the intervention is family-aided assertive community treatment (fact). the goal of the treatment is prevention of psychosis and disability. this study will assess experimentally the clinical effectiveness of this new type of mental health service. other domains of outcome include cognitive dysfunction and functional disability.

the proposed study will be part of a larger program, portland identification and early referral (pier), under foundation, nih and center for mental health services sponsorship, that has established a population-based system of early detection for greater portland, maine. previous and present effort has educated and trained the community-at-large and all health, education and other professionals, with the result that referrals are occurring at the expected frequency. the principal strategy is to intervene early, prior to onset, in the course of the onset of psychotic disorders to arrest the development of psychotic symptoms and functional disability. the test treatment is a specialized combination of psychoeducational multifamily group and assertive community treatment. the project will support a team of clinical staff with the ability to: a. foster detection of prodromal disorders in the greater portland community by general practitioners, guidance counselors, mental health professionals and the general public; b. accurately assess individuals at high risk for psychosis; c. reliably deliver an evidence-based psychosocial and, if indicated, pharmacological treatment package using standardized methodology. the research study will test, in a randomized controlled trial, the symptomatic and functional outcome of treatment in 100 subjects ages 12 to 35 identified by that system. it will allow the analysis of key social factors contributing to psychosis and their interaction with the treatment conditions and each other.

Eligibility criteria:
inclusion criteria: * prodromal psychotic symptoms * age 12-35 * in catchment area (greater portland, maine) exclusion criteria: * previous or current psychotic episode * iq less than 70 * outside catchment area * toxic psychosis

Keywords: prodromal schizophrenia psychosis family psychoeducation assertive community treatment supported employment supported education
effect of water intake and water restriction on total kidney volume in autosomal dominant polycystic kidney disease

Conditions: ADPKD

Summary: the objective of this study is to measure the influence of both short term water restriction and high water intake on total kidney volume, measured by magnetic resonance imaging (mri) scan in autosomal dominant polycystic kidney disease (adpkd) patients.

patients will be randomized to either water restriction for 3 hours or high water intake (20 ml/kg) for 1 hour. before intervention and after intervention patients will have an mri scan of the kidneys to measure the total kidney volume (tkv) (differentiated in cortex, medulla and cyst volume). the objective is to identify whether water restriction or high water load will change the tkv. secondly investigators will analyze different biomarkers (aldosterone, renin, vasopressin/copeptin, urine- and blood-osmolarity) before and after the intervention.

Eligibility criteria:
inclusion criteria: * adpkd * ckd stage 1-3 exclusion criteria: * patients treated with diuretics * pregnancy * change in antihypertensive treatment \< 1 month * any condition contraindicating mr scan

Keywords: adpkd total kidney volume kidney disease
kinesiotaping in carpal tunnel syndrome

Conditions: Carpal Tunnel Syndrome (CTS)

Summary: objective: kinesiotaping (kt) is a relatively new technique, which reduces the pressure on the median nerve by extending the transverse carpal ligament. the aim of this study was to evaluate the effectiveness of kt on carpal tunnel syndrome (cts) in a randomized, placebo-controlled manner. methods: patients were randomly divided into three groups: group 1 (kt plus tendon and nerve gliding exercises), group 2 (sham-taping plus exercises) and group 3 (exercises alone, control group). kt was applied 3 times with 5-day intervals throughout the study, with "neural technique" for median and ulnar nerves and "area correction technique" for carpal tunnel releasing. in the placebo group kinesiotapes were applied without stretching and proper position. hand grip strength, vas, boston carpal tunnel syndrome questionnaire (bctq), and short form-12 (sf-12) were measured as outcome parameters at the first visit, 3rd and 6th week.


Eligibility criteria:
inclusion criteria: * clicical diagnosis of mild and moderate cts * having the cts symptoms for at least 6 weeks exclusion criteria: * electrophysiological diagnosis of severe cts, * thenar atrophy, * local corticosteroid injection or kt application or physical therapy treatment for cts within the last 3 months, * patients with secondary metabolic causes for cts (such as diabetes mellitus, pregnancy, rheumatoid arthritis, sarcoidosis, thyroid disease), * patients with other conditions that may cause neck and arm pain (cervical disc hernia, arthritis, epicondylitis, rotator cuff syndrome), * a history of fracture in the wrist, * previous cts surgery.

Keywords: carpal tunnel syndrome kinesiotaping sham taping
targeted infection control in long-term care

Conditions: Infection

Summary: this is an interventional study aimed at reducing multi-drug resistance and infections in nursing home (nh) residents. each year, a staggering 1.5-2.0 million infections occur in nhs. many of these infections are caused by multiple drug resistant organisms (mdros) including methicillin-resistant staphylococcus aureus (mrsa), vancomycin-resistant enterococci (vre), and multidrug resistant gram-negative bacilli (r-gnb). antimicrobial resistance among common bacteria are adversely affecting the clinical course and exponentially increasing healthcare costs. recognizing a need for action, legislators, policy makers, and consumer groups are advocating for pathogen-based universal preemptive screening for these mdros, particularly mrsa in hospitals and nhs. however, implementing this sweeping mandate is controversial, costly, reactive, and not based on empirical evidence. it can result in a 10-20-fold increase in the number of nh residents placed in isolation precautions with the potential for reduced attention by healthcare workers, isolation and functional decline. the investigators proposal evaluates a novel focused approach between 'do nothing' and 'search all and destroy' strategies by targeting a subgroup of nh residents with indwelling devices who are at a high risk of acquiring mdros and infections. the investigators hypothesize that the investigators targeted infection control program (tip) will reduce mdro colonization and infections in nh residents with indwelling devices. this cluster randomized trial will involve 12 nhs; 6 will be randomized to the tip arm and 6 to the routine care arm. the investigators tip intervention will include four components.

component 1: institute enhanced barrier precautions for all nh residents with indwelling devices; active screening for mdros (monthly) using cultures collected from multiple body sites to identify asymptomatic mdro carriage in these residents; and dissemination of results to clinical staff and administration. component 2: structured, active surveillance for infections using standardized definitions in residents with indwelling devices and dissemination of results to clinical staff and administration. component 3: a hand hygiene promotion program. component 4: a structured educational program pertaining to indwelling device care for healthcare workers.

Eligibility criteria:
inclusion criteria: * any short- or long-stay resident with an indwelling urinary catheter or feeding tube for more than 72 hours * ability to get informed consent from either the resident or his/her durable power of attorney exclusion criteria: * having an indwelling device for less than 72 hours * refusal of consent to get surveillance cultures and data collection by the resident or his/her durable power of attorney * residents who are receiving end-of-life care

Keywords: long-term care nursing homes infection control multi-drug resistant pathogens long-term care residents with in-dwelling devices
preoperative use of alprazolam and hydroxyzine in anxiety

Conditions: Agitation on Recovery From Sedation

Summary: patients will be divided into three groups. group h patients will be given 100 mg hydroxyzine orally 1 hour before surgery while group a patients will receive 0.5 mg alprazolam orally. group p will be placebo group. amsterdam preoperative anxiety and knowledge scale (apais) anxiety scores will be evaluated and recorded 1 hour before surgery. apais score will be evaluated again in the the operation room before surgery started. after base measurements of patients are recorded with standard monitoring, spinal block will be performed with 15 mg heavy bupivacaine from the l2-l3 or l3-l4 levels of spinal cord in sting position. when t10 level sensory block and bromage 0-1 neuromusculer block will be occured , surgery will be started. heart rate, non-invasive arterial blood pressure and the degree of peripheral o2 saturation will be measured at 5 minutes interval throughout the operation. iowa anesthesia satisfaction scale will also performed to the patients the day after the surgery.


Eligibility criteria:
inclusion criteria: * sacrococcygeal dermoid cyst patients * saceptance of spinal anaesthesia * between 18-60 years old patients * asa i-ii exclusion criteria: * drug allergy * bmi\>35kg/m2 * psychiatric disorders * serious renal and hepatic damage * coagulation disorders * serious cardiac and respiratory disorderders * rejection of spinal anesthesia
blood flow restriction resistance training intervention on vascular function

Conditions: Endothelial Function

Summary: the purpose of this study is to investigate the effect of blood flow restriction (bfr) resistance training on vascular function. the investigators aim to compare the effects of different bfr devices (wide-rigid cuffs and narrow elastic bands) on vascular function. the investigators hypothesize that bfr resistance training with wide-rigid cuffs might have a minor negative effect (short-term and reversible) on vascular function, while bfr resistance training with narrow-elastic bands may improve vascular function. both training methods are equally effective in increasing muscle strength.

blood flow restriction (bfr) resistance training has been proven to be effective in increasing muscle mass and strength. during bfr training, cuffs (similar to blood pressure cuffs) are placed on the proximal ends of the extremities to partially occlude arterial blood flow to the working muscles and fully restrict venous outflow from the working muscle. the metabolites produced by the working muscle during exercise are trapped in the working muscle, which causes metabolic stress to augment muscle adaptation. typically, two types of cuffs are used in the bfr training: the narrow-elastic bands and wide-rigid nylon cuffs adapted from surgical tourniquets and blood pressure cuffs. currently, the effect of bfr training on vascular function remains unclear. when the cuffs are removed after bfr training, there will be a reactive hyperemic blood flow to wash out all the metabolites produced during exercise. this reactive hyperemic blood flow also will impose shear stress on the arterial vessel wall. the shear stress will lead to an increase in vasodilator factors, which lead to an improvement in vascular function. however, other studies have pointed out that bfr training might cause a negative effect on vascular function when the occlusion pressure was too high. the possible mechanisms of the negative effect might be ischemia-reperfusion injury and retrograde shear stress in the artery. the wide-rigid cuffs are easily available but have the potential to inhibit the expansion of muscle upon increased blood flow accompanying exercise and muscle contraction while the narrow-elastic bands do not prevent the expansion. to the investigators' best knowledge, there is no study directly comparing different bfr cuffs on vascular function. thus, the aim of the present study is to compare the effects of different bfr cuffs on vascular function (evaluated by flow-mediated dilation, a non-invasive measure of endothelial-derived vasodilation).

Eligibility criteria:
inclusion criteria: * apparently healthy, sedentary or recreationally active young adults aged between 18 - 40 years old and signed the informed consent. exclusion criteria: * a current covid-19 diagnosis * morbid obesity * hypertension * smoking * overt cardiovascular disease * using any medication that might affect the cardiovascular system * current participation in resistance training.
the prospective clinical study of precision prag therapy in elderly patients with advanced solid malignant tumors (prag9.0)

Conditions: Carcinoma; Solid Tumor

Summary: this is an open-label, single-arm, phase ii investigator-initiated trial of hypofractionated radiotherapy combined with pd-l1 inhibitor sequential gm-csf and thymopentin for treatment of elderly patients with advanced solid tumors, when the her-2 positive patients are treated with extra antibody-drug conjugate.


Eligibility criteria:
inclusion criteria: * aged 75 years and above * standard treatment is ineffective (disease progresses after treatment) or locally advanced or metastatic malignant solid tumor patients who cannot tolerate standard therapy, cannot receive or do not have standard therapy * ecog(eastern cooperative oncology group) performance is 0-3 * life expectancy greater than 3 months * serum aspartate transaminase (ast) and serum alanine transaminase (alt) ≤3.0\*uln, or ast and alt≤5\*uln with hepatic metastasis; total serum creatinine ≤1.5\*uln * signed informed consent form exclusion criteria: * current pregnancy or lactation * history of other malignant tumors within 5 years prior to dose administration, expect for#malignancies that can be cured after treatment (including but not limited to adequately treated thyroid cancer, cervical carcinoma in situ, basal or squamous cell skin cancer) * uncontrolled epilepsy, central nervous system diseases or mental illness * arrhythmia, congestive heart failure, or greater than or equal to class 2 congestive heart failure as defined by the new york heart association functional classification, or history of myocardial infarction unstable angina, or acute coronary syndrome within 6 months prior to enrollment in the study * received allogeneic hematopoietic stem cell transplantation or solid organ transplantation * other serious, uncontrolled concomitant diseases that may affect protocol compliance or interpretation of outcomes, including active opportunistic infections or advanced (severe) infections, uncontrolled diabetes * allergic to any of the ingredients used in the study * a history of immunodeficiency, including hiv positive or other acquired or congenital immunodeficiency disease, or a history of organ transplantation, or other immune-related disease requiring long-term oral hormone therapy * acute and chronic tuberculosis infection * other disorders with clinical significance according to the researcher's judgment
nationwide cohort study of antiplatelet agents as primary prevention

Conditions: Coronary Artery Disease; Coronary Artery Stenosis

Summary: there is no specific recommendation regarding pharmacologic treatment as primary prevention for patients with intermediate coronary artery stenosis whose revascularization was deferred based on negative fractional flow reserve (ffr). current nationwide cohort study conducted using korean national health insurance service database evaluated the safety and efficacy of antiplatelet therapy in patients with intermediate coronary artery stenosis with deferred revascularization based on negative ffr (ffr\>0.80).

this study was nationwide cohort study conducted using korean national health insurance service database. from 2013 to 2020, reimbursement criteria of ffr were patients with no previous evidence of myocardial ischemia and intermediate coronary artery stenosis (50-70%). patients who were evaluated by coronary angiography and ffr but did not undergo revascularization were selected and classified according to the use of antiplatelet agents after index procedure. patients with previous history of atherosclerotic cardiovascular disease were excluded. eligible patients were matched using propensity score in a 1:1 ratio. primary efficacy outcome was major adverse cardiac and cerebrovascular events a composite of all-cause death, myocardial infarction, unplanned revascularization, and stroke at 5-year. primary safety outcome was gastrointestinal bleeding, regardless of the need of transfusion.

Eligibility criteria:
inclusion criteria: * patients with 50-70% intermediate stenosis by quantitative coronary angiography in a vessel greater than 2.5 mm * patients who underwent invasive coronary angiography and ffr measurement * patients whose revascularization was deferred based on ffr\>0.80 exclusion criteria: * patients who underween ffr measurement after expansion of reimbursement criteria of ffr (since 2021) * patients with history of any bleeding with blood transfusion * patients with use of non-vitamin k antagonist oral anticoagulants (noac) or warfarin * patients with previous atherosclerotic cardiovascular disease * patients with already on antiplatelet agents including dual antiplatelet agents

Keywords: coronary artery stenosis antiplatelet agent fractional flow reserve prognosis
effects of aquatic vs land based jogging in overweight

Conditions: Overweight

Summary: obesity raises the risk of chronic illnesses in adults, especially heart disease, type ii diabetes, and osteoarthritis. one way to combat obesity is by physical activity, and water-based exercise (hydrotherapy) is recognized as an enhancement of the more common on land physical activity. obesity is associated with several negative health outcomes, including cardiovascular disease (cvd), cardiac enlargement, gallbladder disease, diabetes, several cancers, osteoarthritis, and sleeping disorders .in addition to being a significant predictor of coronary heart disease and heart failure. obesity is indirectly related to cardiovascular health through its association with several other cvd risk factors, including hypertension, high cholesterol, low high-density lipoprotein (hdl) cholesterol, high triglycerides, and diabetes therefore, obesity is a primary target for interventions to decrease overall cardiovascular risk. it is a randomized clinical trial conducted at the university of central punjab lahore. convenience sampling technique will be used .participants will be recruited through simple random sampling by sealed opaque envelope method into two groups .group a and group b. group a:aqua jogging group: this group will perform aqua jogging for 60 minutes consisting of 10 minutes warming up, 40 minutes aqua jogging or land jogging and 10 minutes cooling down. group b: land based jogging group: this group will perform land jogging for 60 minutes consisting of 10 minutes warming up, 40 minutes aqua jogging or land jogging and 10 minutes cooling down. assessment tools for this study will be cooper's 1.5 miles run test for cardiorespiratory endurance and health related quality of life questionnaire for quality of life. the study will be completed within 10 months after synopsis approval from ethical committee of rcrs \& ahs .data will be entered and analysed by spss version 25. after assessing the normality of data, it will be decided either parametric or non-parametric test will be use within a group or between two groups.


Eligibility criteria:
exclusion criteria: * individuals having exercise induced asthma * any skin disease- open wound infection * participants having hydrophobia * individuals with chronic issues \& physical defects * participants with cognitive impairments * ongoing medications that would be of lipid metabolism, menstruation, history of gastrointestinal infection inclusion criteria: * bmi: 25 - 30 kg/m2 * gender: both * age: 20-59 years

Keywords: aqua jogging endurance hydrotherapy land jogging overweight quality of life
effect of non-psychoactive cannabidiol as an adjunct to botulinum toxin in blepharospasm

Conditions: Blepharospasm; Blepharospasm, Benign Essential; CBD

Summary: the planned study is a prospective analysis of non-psychoactive cannabidiol (without thc) as an adjunctive therapy for blepharospasm in a masked double cross-over study. this prospective study is a follow-up to a retrospective study completed by the researchers using over-the-counter, self purchased cbd. this study will use fda approved cannabidiol medication, epidiolex, directly from gw pharmaceuticals, rather than self-purchased cbd from the internet. patients will undergo videorecording with a high resolution videocamera system at days 0, 45, 90, 135, and 180 using a novel blink analysis to gather objective data measurements of changes induced by cbd in blepharospasm patients. this study will attempt to codify the data and quantify if adjunctive cbd therapy improves those areas compared to botulinum injection alone.


Eligibility criteria:
inclusion criteria: * patients in the private practice of the principal investigator with an icd code of "blepharospasm" and: * undergoing routine maximal botulinum therapy * experiencing break through symptoms of spasm * marijuana naïve exclusion criteria: * concomitant diagnosis of epilepsy * patients whom are not marijuana naive * patients on concurrent anti-epileptics * patients who are pregnant or wishing to become pregnant * patients not wishing to participate in the study.

Keywords: cannabidiol epidiolex botulinum toxin eyeblink analysis videorecording blepharospasm beb